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Study: Mammography Hasn’t Affected Mortality

June 13, 2013
Written by: , Filed in: Breast Imaging
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Another bombshell in the mammography wars has exploded: a study in the June issue of Journal of the Royal Society of Medicine concludes that mammographic screening in England has had no discernible effect on mortality from breast cancer.

Researchers at the Department of Public Health of the University of Oxford in the United Kingdom examined death certificates to find women who died from breast cancer in England from 1971 through 2009. They were looking for any changes in the breast cancer mortality rate after the English National Breast Screening Programme was introduced in 1988.

The breast screening program invites every woman within a specific age range to receive free mammography screening every three years. The initial age range was 50 through 64. In the early 2000s, the upper age increased to 70. The program is now phasing in an extension of the age group to 47–73.

Here’s the new study’s key finding:

We sought evidence of a decline in population-based breast cancer mortality that could be attributed to the implementation of mammographic screening programmes. We conclude that population-based mortality statistics, at least in England, do not show a past benefit of breast cancer screening.

During the study period, mortality rates from breast cancer did decline, and significantly. The study found an all-age-groups decline of 30.9 percent since 1989, the year of peak mortality. However, the study says, “There is no evidence that declines in mortality rates were consistently greater in women in cohorts that had been screened at all, or screened several times, than in other (unscreened) women in the same time periods.”

So what accounts for the mortality decrease if not mammographic screening? The study suggests improvements in breast cancer treatment and changes in such risk factors as childbearing patterns.

The study does say mammography may benefit individual women, but “these effects are not large enough to be detected at the population-level.”

Reading the study, you get the impression that the authors regret not being able to show that mammography led to a decline in breast cancer mortality. Note, for example, the wording of the final sentence: “We permuted the data in a number of different ways, over an observation period of 39 years, but the data show that, at least as yet, there is no evidence of an effect of mammographic screening on population-level breast cancer mortality.”

Related CME seminar: Chicago International Breast Course and The Society for the Advancement of Women’s Imaging

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